The inhibitors and enablers of emerging adult COVID-19 mitigation compliance in a township context

BackgroundConsidering its pandemicity and absence of effective treatment, authorities across the globe have designed various mitigation strategies to combat the spread of COVID-19. Although adherence towards preventive measures is the only means to tackle the virus, reluctance to do so has been reported to be a major problem everywhere. Thus, this study aimed to assess the community’s adherence towards COVID-19 mitigation strategies and its associated factors among Gondar City residents, Northwest Ethiopia.MethodsA community-based cross-sectional study was employed among 635 respondents from April 20–27, 2020. Cluster sampling technique was used to select the study participants. Data were collected using an interviewer-administered structured questionnaire. Epi-Data version 4.6 and STATA version 14 were used for data entry and analysis, respectively. Binary logistic regressions (Bivariable and multivariable) were performed to identify statistically significant variables. Adjusted odds ratio with 95% CI was used to declare statistically significant variables on the basis of p < 0.05 in the multivariable logistic regression model.ResultsThe overall prevalence of good adherence towards COVID-19 mitigation measures was 51.04% (95%CI: 47.11, 54.96). Female respondents [AOR: 2.39; 95%CI (1.66, 3.45)], receiving adequate information about COVID-19 [AOR: 1.58; 95%CI (1.03, 2.43)], and favorable attitude towards COVID-19 preventive measures were significantly associated with good adherence towards COVID-19 mitigation measures. Whereas, those respondents who had high risk perception of COVID-19 were less likely to adhere towards COVID-19 mitigation measures [AOR: 0.61; 95% CI (0.41, 0.92)].ConclusionsThe findings have indicated that nearly half of the study participants had poor adherence towards COVID-19 mitigation measures. Sex, level of information exposure, attitude towards COVID-19 preventive measures, and risk perception of COVID-19 were factors which significantly influenced the adherence of the community towards COVID-19 mitigation measures. Therefore, it is crucial to track adherence responses towards the COVID-19 preventive measures, scale up the community’s awareness of COVID-19 prevention and mitigation strategies through appropriate information outlets, mainstream media, and rely on updating information from TV, radio, and health care workers about COVID-19.

This study aimed to explore adolescents and young adults' experiences of symptoms related to their eczema in order to determine their psychosocial needs. A secondary qualitative analysis of two data sources collected through semi-structured interviews for two different projects, SKINS project and Eczema Care Online project. In total, there were 28 transcripts with adolescents and young adults with eczema having a mean age of 19.5years available to analyse. Interview data were collected from face-to-face interviews that were recorded and transcribed. Inductive thematic analysis explored data about symptoms and organized according to psychosocial needs. Adolescents and young adults with eczema experience both visible symptoms (such as flaky, dry, and inflamed skin) and invisible symptoms (such as itch, pain, exhaustion, and mental distress) that elicit different psychosocial needs. These psychosocial needs are to (i) be understood; (ii) be perceived as normal; and (iii) receive emotional support. Interviewees described a struggle between wanting their peers and family to understand but take their eczema seriously whilst not wanting to stand out and instead to be perceived as 'normal', which they would define as being perceived as other adolescents. This has implications on behaviours, such as seeking support, avoiding going out, hiding their skin, as well as emotional implications, such as social isolation and feeling anxious and low. Having a better understanding of young people's experiences and psychosocial needs will provide a framework on how best to support adolescents and young adults when managing symptoms related to eczema. Statement of contribution What is already known on this subject? Eczema has a high impact on children and is considered a burden by children and adults with eczema. However, it is unclear what impact eczema has on adolescents and young adults. Adolescents and young adults with chronic conditions are known to be vulnerable to negative psychosocial outcomes but psychosocial needs and how to best support this age group with eczema are unknown What does this add? Three psychosocial needs were developed from evaluating the impact of visible and invisible symptoms of eczema: The need to feel understood (mostly reflective of invisible symptoms such as itch and pain and visible symptoms such as scratching). The need to be perceived as 'normal': visible symptoms such as flaky, inflamed skin make them stand out in comparison with their peers and a need emerged to blend in. The need for emotional support: adolescents and young adults searched for this from their health care providers, from shared experiences and from online resources. Adolescents and young adults with eczema appear to feel ambivalent about wishing the impact of the condition to be acknowledged whilst wishing the condition to be invisible to others. This ambivalence had further impact on feeling self-conscious, seeking support, and dealing with unsolicited advice.

Even after enactment of the Protection of Women From Domestic Violence Act 2005, over the last 10 years, the rate of decline of prevalence of spousal violence against women has remained low in India. This study attempts to explain the experience of spousal violence using a social-ecological framework. We analyzed the National Family Health Survey 2015 to 2016 (NFHS-4) data of 66,013 ever-married women aged 15 to 49 years. Participants in the domestic violence module of the NFHS-4 reported their experience of violence committed by their husband within the 12 months preceding the survey. Multilevel logistic regression analyses were done to determine the association between spousal violence and different explanatory variables of various levels of social ecology including variables on women's empowerment. About one fourth of ever-married women reported experiencing any form of violence during the last year. The experience of spousal violence was significantly associated with social ecology at multiple levels. At the individual level, the odds of experiencing physical violence were higher among younger women, who married at a younger age, had an age gap of 3 to 4 years with her husband, and had more children. Women in vulnerable groups, with poor economic status, and members of marginalized communities had higher odds of experiencing spousal violence. Women had high odds of experiencing spousal violence if living in a social ecology with unfavorable social norms, higher rates of domestic crimes, and a higher prevalence of underage marriage. The association of spousal violence with women's empowerment remained inconclusive. The results argue for manipulating contextual factors to empower women to challenge gender-related equations and investing in education for gender sensitization at the higher level social ecologies.

Purpose of ReviewThe COVID-19 pandemic has impacted daily-life activities around the world. Multiple countries and cities are implementing different mitigation strategies to reduce their transmission (e.g., physical distancing, stay-at-home orders, avoiding large gatherings). Such interventions have been related to positive and negative health externalities. Currently, the selection of mitigation strategies has not been systematically considering a long-term vision for urban health equity. This review presents evidence and a framework linking COVID-19 mitigation strategies, the built environment, and transport to health determinants and outcomes. In addition, the paper provides a set of urban interventions aimed at supporting COVID-19 mitigation strategies and promoting a long-term health equity vision.Recent FindingsCOVID-19 mitigation strategies, in addition to helping reduce disease transmission, have also decreased urban road transport, resulting in indirect benefits on air quality, traffic noise, and traffic incidents. On the other hand, the same mitigation strategies have had negative impacts on physical activity, mental health, home isolation, and access to transport options, among others. COVID-19 mitigation strategies are an opportunity to test and implement built environment and transport interventions aimed to maximize health equity and minimize health risks. National and local authorities should systematically integrate a long-term urban health equity vision when designing and implementing COVID-19 mitigation strategies.SummaryCOVID-19 offers an opportunity to rethink the built environment and transport infrastructure with the aim to support short-term mitigation strategies and reduce long-term urban health inequities.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40572-021-00307-7.

Covid-19 Pandemic is a global issue affecting higher education institutions, including colleges for future government officials like the Polytechnics of Correctional Science and the Polytechnics of Immigration. To present a research article regarding this issue, the qualitative method and the interview technique were used for this purpose. The data were collected based on interviews with actors involved in mitigating Covid-19 in those Polytechnics. As the result of interviews, several strategies for Covid-19 mitigation are obtained. They include strengthening the role of leadership in finding solutions in uncertain conditions, campus zoning, providing quarantine and self-isolating facilities, conducting tracing, testing, treatment, and other health protocols. In addition, the Covid-19 mitigation strategies also include implementing virtual learning methods during pandemics and providing access to anti-virus medicines, vitamins, and other kinds of supplements for employees and students. The campus management also conducts mitigation strategies by accompanying students during isolation, educating students and staff about self-protection from the virus, establishing a campus task force to organize mitigation activities, and also conducting coordination with other stakeholders. Overall, the research shows that the Covid-19 mitigation strategy in Poltekim and Poltekip campuses is quite effective. However, improvements in several areas are needed in the future. Regarding the strategy for Covid-19 mitigation in higher education institutions, the authors recommend several proper prevention strategies such as increasing the number of rooms and facilities to accommodate classes with health protocols and agreeing on a common perception among stakeholders about the learning, coaching, and methods of treatment in these colleges.

Supporting Young Adults to Rise to the Challenge of COVID-19

Social, structural and systemic factors are critical to understanding drug-related deaths among adults. The relevance of these factors to young people is not known. This study explores the life experience, drug using histories and the interactions of a group of young people with agencies and services prior to their death. Our approach seeks to look beyond the immediate cause of death and identify broader contextual factors that may have contributed to a death through a "whole-life view". The study developed a socio-ecological autopsy approach informed by social autopsy methods and social ecology and risk environment frameworks. Health, social work, police and post-mortem records of the young people were collated and analysed. Summary narratives, chronologies and descriptive statistics were produced using Excel and NVivo. Twenty-one deaths were identified; almost all were due to multi-drug toxicity, mainly heroin mixed with other substances. Almost all the young people had reported mental health issues such as anxiety, depression and self-harm, and had experinced at least one recorded overdose before they died. Most grew up in precarity and poverty in deprived areas. In their short lives, most of this cohort of young people experienced multiple adversities in childhood and as young adults, particularly in the year preceding their death. Complex and fragmented services struggled to respond holistically to early signs of difficulties and to the young people's cumulative experience of trauma and adversity, mental ill-health and drug-related harms in the context of prohibition. There is a need for a radical rethink of systems to enable integrated youth-centred approaches that meet the needs of those at risk of drug-related deaths and to address the broader social and structural contexts of drug deaths.

Prevention and health promotion in school and community settings: a commentary on the international perspective

BackgroundEarly Care and Education (ECE) sites are critical hubs for social, emotional, and physical learning development of preschool children (ages 3–5). The COVID-19 pandemic has impacted ECE enrollment and participation; until June 2022, preschool children in the US were ineligible for COVID-19 vaccines. It is critical to identify perceptions of teachers/directors and parents to enhance safe return-to-school efforts.MethodsFocus groups (n = 7; 22 participants) were conducted with ECE teachers/directors throughout Arizona to examine perceptions of COVID-19 testing for families and staff at ECE sites, and current and possible COVID-19 mitigation strategies during Summer 2021. Preschool parents from underserved families in Phoenix (n = 41) completed a brief survey on their perceptions of benefits of ECE for themselves and their children, thoughts on COVID-19 mitigation strategies, and timing for safe return to school during Spring 2021. Focus groups were transcribed and analyzed for themes using constant comparison.ResultsThere were 4 focus group themes: 1) perceptions of saliva-based COVID-19 testing, 2) logistical strategies for COVID-19 testing at ECE sites; 3) successes and challenges with current COVID-19 mitigation strategies; 4) ideas to support improved COVID-19 mitigation, including outdoor gardening. Parents rated peace of mind about the child’s education as the most important benefit for themselves of in-person ECE (74.6%), and social development for children as the most important benefit for their children (54.4%). Over 40% of parents reported it would not be safe to send children back until 2022.ConclusionsCOVID-19 continues to impact attendance at ECE sites, despite parents reporting key benefits to attending ECE sites. Teachers/directors supported COVID-19 mitigation strategies including saliva-based testing and gardening education to improve safe return to schools.

Millions of acute conjunctivitis cases occur in the United States annually. The impact of COVID-19 mitigation practices on viral conjunctivitis incidence within ophthalmology clinics has not been reported. We hypothesized that viral conjunctivitis rates would decrease with implementation of such practices. A retrospective chart review was conducted at a single academic center's ophthalmology clinics. Electronic health record data was queried using ICD-10 diagnostic codes to include 649 patients aged 2-97 with viral, bacterial, or allergic conjunctivitis diagnosed either before (6/1/2018-5/1/2019) or during (6/1/2020-5/1/2021) COVID-19 precautions. Conjunctivitis rates per ophthalmology clinic visit were compared using rate-ratio analysis. Logistic regression evaluated the effects of age, sex, and race among those with conjunctivitis. A total of 66,027 ophthalmology clinic visits occurred during the study period. Viral conjunctivitis rates per visit did not significantly change after enacting COVID-19 mitigation strategies, but allergic conjunctivitis rates significantly increased (viral: RR 0.82, 95% CI 0.51 to 1.31, p=0.408; allergic: RR 1.70, 95% CI 1.43 to 2.03, p<0.001). When controlling for time, younger age (≤ median age 55) (p=0.005) and Caucasian race (p=0.009) were associated with higher viral conjunctivitis frequency. Contrary to trends reported in emergency departments, viral conjunctivitis rates within an ophthalmology clinic did not significantly change after COVID-19 mitigation strategies, though allergic conjunctivitis rates increased. Patients' avoidance of emergency departments during the pandemic may have contributed. Further investigation is required to explore variation in ophthalmology patient populations and needs based on care setting.

To examine the relationship between incarceration history and an individual's compliance toward COVID-19 mitigation strategies and vaccination status/intentions. Data are from the Crime, Health, and Politics Survey (N = 1,735), a national probability sample of community-dwelling adults aged 18 and above living in the United States. Data were collected from May 10, 2021 to June 1, 2021. Multinomial logistic regression models were used to assess the relationship between incarceration history and COVID-19 mitigation strategies and vaccination status/intentions. Individuals with a history of incarceration reported approximately twice the relative risk of rarely/never using hand sanitizer and rarely/never wearing a mask compared with always/very often. Incarceration history was associated with more than 3 times greater relative risk of reporting not being vaccinated and not planning to get vaccinated compared with currently being vaccinated. Formerly incarcerated individuals are less likely to abide by key COVID-19 mitigation protocols and exhibit higher levels of vaccine hesitancy. These findings suggest that formerly incarcerated individuals, as well as their families and communities, may therefore be at greater risk of accelerated spread of COVID-19 because of these factors.

At the onset of the COVID-19 pandemic, schools closed across the United States. Given the impact of virtual learning and lost access to school resources, schools eventually reopened with COVID-19 mitigation protocols in place. This qualitative study sought to understand parental perceptions of school-based COVID-19 mitigation strategies. Using a phenomenology approach, nine focus groups were completed with 40 parents of children in grades K-8 representing eight Maryland counties. Based on acceptance of masking policies (as indicated on a survey), parents were sorted into 2 groups-lower and higher masking acceptance. A thematic analysis was conducted for each group and themes were compared between the 2 groups. The main themes were related to parents' general sentiments regarding COVID-19, compliance, pandemic-related changes over time, changes in personal opinions, and in-person learning. Both groups described challenges related to inconsistent COVID-19 mitigation policies and practices, the challenges of rapid and frequent changes in guidelines during the pandemic, and the benefits of in-person learning. Parents of elementary and middle school children, regardless of general acceptance of masking policies, shared concerns about implementation and guidance regarding school-based mitigation strategies.

The Journal of Adolescent Health's Editor-In-Chief's Annual Reflection: A Year of COVID, Coping, and Creativity

Peer-led and youth-led sex education primarily involves young people teaching other young people about sex, sexuality, and sexual health. This approach gained in popularity during the HIV/AIDS crisis of the 1980s–1990s, as community organizations sought to address the unique sexual health needs of lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth, many of whom had been underserved in traditional sex education spaces. Since then, peer-led and youth-led sex education pedagogies have been implemented by researchers, educators, and community organizations working across a range of sites around the globe. Peer-led and youth-led sex education generally draws on assumptions that young people are better situated than adults to talk to their peers about sexual health and/or to model positive sexual health behavior. However, some have noted that this perspective constructs young people as a homogenous group and ignores the ways in which sexuality and sexual health intersects with other social factors. Furthermore, there is a general lack of consensus across interventions around who constitutes a “peer” and what constitutes “peer-led” sex education, resulting in the development of interventions that at times tokenize young people, without engaging them in meaningful ways. As a result, evaluations of many peer- and youth-led sex education pedagogies suggest that even as these pedagogies improve young people’s knowledge of sexual health-related topics, they often don’t result in long-term sexual health behavior change. However, many evaluations of peer- and youth-led sex education pedagogies do suggest that acting as a peer educator is of immense benefit to those who take on this role, pointing to the need for program developers to reconsider what effective sex education pedagogy might look like. A “social ecology” or “systems thinking” approach to youth sexual health may provide alternative models for thinking about the future of peer-led and youth-led sex education. These approaches don’t task peer- and youth-led sex education with the sole responsibility of changing young people’s sexual health-related outcomes, but rather situate peer-led sex education as one potential node in the larger confluence of factors that shape and constrain young people’s sexual health.

The majority of research on out-of-school-time activity participation has focused on its relation to academic and social development, presumed to be consequences of participation, rather than on antecedents or predictors of participation. Understanding who participates in these programs can assist program directors in improving and sustaining youth involvement. This chapter uses data from two research study samples to examine differences in children's activity participation based on family social ecology and child gender and how the relations between participation and outcomes vary based on sample, gender, and activity type. Although children in both samples were of roughly the same age and were assessed for similar outcomes, their family incomes, socioeconomic status, ethnicity, and neighborhoods were very different. Findings suggest that participation in activities varies depending on the young person's social ecology, age, and gender. Furthermore, participation in activities was typically associated with positive youth outcomes, but these relations varied depending on the level of youth participation, type of activity, and social ecology.